Opium use and subsequent incidence of cancer: results from the Golestan Cohort Study
Abstract
Summary Background Evidence is emerging for a role of opiates in various cancers. In this study, we aimed to investigate the association between regular opium use and cancer incidence. Methods This study was done in a population-based cohort of 50 045 individuals aged 40–75 years from northeast Iran. Data on participant demographics, diet, lifestyle, opium use, and different exposures were collected upon enrolment using validated questionnaires. We used proportional hazards regression models to estimate hazard ratios (HRs) and corresponding 95% CIs for the association between opium use and different cancer types. Findings During a median 10 years of follow-up, 1833 participants were diagnosed with cancer. Use of opium was associated with an increased risk of developing all cancers combined (HR 1·40, 95% CI 1·24–1·58), gastrointestinal cancers (1·31, 1·11–1·55), and respiratory cancers (2·28, 1·58–3·30) in a dose-dependent manner (ptrend<0·001). For site-specific cancers, use of opium was associated with an increased risk of developing oesophageal (1·38, 1·06–1·80), gastric (1·36, 1·03–1·79), lung (2·21, 1·44–3·39), bladder (2·86, 1·47–5·55), and laryngeal (2·53, 1·21–5·29) cancers in a dose-dependent manner (ptrend<0·05). Only high-dose opium use was associated with pancreatic cancer (2·66, 1·23–5·74). Ingestion of opium (but not smoking opium) was associated with brain (2·15, 1·00–4·63) and liver (2·46, 1·23–4·95) cancers in a dose-dependent manner (prend<0·01). We observed…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,833 participants or records.
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